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REPAIR OF HUGE INCISIONAL HERNIA OF AB DOMINAL WALL WITH SOFT—TISSUE—CUTA NEOUS FLAP ADJACENT TO HERNIA

The soft-tissue-cutaneous flap adjacent to the abdominal incisional hernia was ultilized to repair huge hernia in 6 cases with success. Patients were followed up for 2y7 years without recurrence. The operative planning, the technique and the matters needing attention were introduced in details. The soft tissues and skin adjacent to hernia used for repair was easy to obtain and a simple technique. The adoption of this operation in hospitals at the grassroots level was feasible.

應用聚丙烯網片修復成人腹部切口疝

胸骨正中小切口在心臟直視手術中的應用

目的 介紹胸骨正中小切口在心臟手術中的應用效果. 方法 風濕性心瓣膜病或先天性心臟病患者40例,分別在常規體外循環或常溫心臟不停跳下行心內直視術.做胸骨下端正中小切口,長5～9cm,保留胸骨柄的連續性. 結果 手術均順利進行,術后無嚴重并發癥發生,循環穩定,恢復快,瘢痕隱蔽.心臟不停跳手術患者,術后輔助呼吸和使用正性肌力藥物的時間明顯縮短. 結論 胸骨正中小切口可以安全的應用于多種常規和心臟不停跳心內直視手術,適應范圍廣、創傷小、手術效果好和美容效果佳.

小切口松解治療伸直型膝關節僵直

【摘 要】 目的 總結小切口松解治療伸直型膝關節僵直的臨床效果。 方法 2004 年3 月－ 2007 年1 月，采用小切口松解治療伸直型膝關節僵直34 例。男26 例，女8 例；年齡18 ～ 58 歲。病程8 ～ 36 個月。病因：骨折30 例，交叉韌帶損傷3 例，滑膜損傷1 例。術前膝關節平均屈曲35°。患者均采用膝關節外側弧形小切口松解粘連，術后24 h 即進行CPM 機鍛煉。 結果 患者切口均Ⅰ期愈合。34 例獲6 個月～ 2 年隨訪。膝關節屈曲均達90° 以上，股四頭肌肌力正常，無髕前皮膚壞死發生。按劉國輝等療效評定標準，優25 例，良8 例，中1 例，優良率97%。 結論 小切口松解治療伸直型膝關節僵直創傷小，可早期行膝關節功能鍛煉，術后并發癥少，關節功能恢復好，是治療伸直型膝關節僵直的一種較好方法。

Posterior InnerSide Incision and Antiskid Steel Plate for Treatment of Complex Fractures of Tibial Plateau

目的:探討輔助后內側切口及抗滑鋼板治療復雜脛骨平臺骨折的臨床療效。方法:對我院2006年4月至2008年12月的28例復雜脛骨平臺骨折病患(男19例,女9例,平均年齡37歲)進行輔助后內側切口及抗滑鋼板的臨床手術治療。結果:術后隨訪,24例效果良好,4例出現不良反應,經修復后愈合。結論:術后關節功能及切口恢復良好,外側支撐鋼板+后內側抗滑鋼板的雙切口雙鋼板的手術方法是治療復雜脛骨平臺骨折安全、有效的方法,故在臨床上有推廣價值,但有待大規模病例來驗證。

STUDY OF THE MAGNETIC PIECE DRESSINGS OF DIFFERENT INTENSITIES ON THE EFFECT OF SURVIVAL OF SKIN FLAPS AND HEALING OF INCISIONAL WOUNDS

The comparative study of local application of magnetic piece dressings of different intensities (Gs) on the effect of survival of 48 skin flaps (2×5cm in size) and the healing of the incisional wornds was reported. Twelve Japanese long ear white rabbits were used for this study. It was noted that the magnetic field intensity of 200or 400 Gs showed remarkable increase of the area of survival of the skin flaps and enhancement of the healing of the incisional wounds.

Treatment with Miniature Incision at the End of Bile Duct of Stone（Report of 110 Cases）

目的探討小切口膽總管末端結石的治療。方法對110例膽總管末端結石患者采用小切口術中膽道鏡、氣囊導管等治療的臨床資料進行回顧性總結。結果術中采用膽道鏡、氣囊導管等清除末端結石86例（78.2%）。術后用膽道鏡取出結石10例（9.1%），膽道鏡聯合內鏡乳頭括約肌切開技術清除結石14例（12.7%）。術中18例(16.4%）并發膽總管末端醫源性損傷，其中1例術后并發消化道大出血死亡，其余病例經2~20年隨訪無遠期并發癥。結論膽總管末端結石采用小切口術中膽道鏡、氣囊導管等相結合能清除多數結石，難以取出的末端結石于術后經內鏡處理為妥。

Application of Bilayer Polypropylene Mesh in Repair of Abdominal Incisional Hernia

目的 探討應用人工合成材料雙層聚丙烯補片修補腹壁切口疝的效果。方法 21例腹壁切口疝（15例大切口疝和及6例巨大切口疝）患者采用雙層聚丙烯補片行無張力修補，對術中及術后情況進行分析。結果 全組病例手術順利，手術時間 87～189 min，平均123 min。無嚴重并發癥發生，痊愈出院。術后隨訪5～36個月（平均 17個月），無復發病例。結論 雙層聚丙烯補片修補中下腹壁大切口疝及巨大切口疝是一種安全、有效的方法，是臨床上治療切口疝可供選擇的一種手術方式。

Clinical Outcomes of Left Atrial Myxoma Resection via Right Anterolateral Minithoracotomy

ObjectiveTo investigate clinical outcomes and safety of minimally invasive left atrial myxoma (LAM) resection via right anterolateral minithoracotomy (ALMT). MethodsClinical data of 9 patients who underwent minimally invasive LAM resection via right ALMT in the Affiliated Hospital of Luzhou Medical College from January 2011 to October 2013 were retrospectively analyzed. There were 2 male and 7 female patients with their age of 37-62 (51±9) years. The operation was performed through a small (4-6 cm) right ALMT incision. Femoral artery and vein and superior vein were cannulated to establish cardiopulmonary bypass (CPB). Transthoracic clamp was used for ascending aortic clamping. Antegrade cold blood cardioplegia was infused for myocardial protection. LAM was resected through right atriotomy trans-septal approach. ResultsAll the operations were successfully performed without in-hospital death. Operation time was 210-310(260±33) minutes, aortic cross-clamping time was 23-50(37±9) minutes, CPB time was 60-87(71±9) minutes, postoperative mechanical ventilation time was 6-14(9.0±2.5) hours, and length of ICU stay was 17-26(20±3) hours. Postoperative mediastinum drainage was 100-650(376±190) ml. Mean length of right ALMT was 4.5-6.0 (5.3±0.6) cm. All the patients were followed up for 1 to 30 months,and echocardiography showed no LAM recurrence. ConclusionMinimally invasive LAM resection via right ALMT is safe and feasible with satisfactory clinical outcomes.

Early outcomes of surgical treatment for patent ductus arteriosus combined with intracardiac abnormity via right vertical infra-axillary thoracotomy

ObjectiveTo explore the early outcomes of the surgical treatment for patent ductus arteriosus (PDA) combined with intracardiac abnormities via right vertical infra-axillary thoracotomy (RVIAT).MethodsA total of 7 children with PDA combined with intracardiac defects underwent surgery through RVIAT at the Second Affiliated Hospital of Nanjing Medical University from 2016 to 2018. There were 4 males and 3 females, with an average age of 5.3±4.5 years and weight of 18.0±11.2 kg.ResultsIn all patients, PDA was ligated before the repair of intracardiac abnormities. No patient died in hospital. All patients were followed up, with a mean follow-up time of 18.0±8.0 months. No other complications such as residual shunts, arrhythmias, hemorrhaging or wound infection occurred after operations or during the follow-up period.ConclusionRVIAT is an emerging technique used for the surgical repair of PDA combined with intracardiac defects. It yields satisfying cosmetic results, without increasing postoperative complications or mortality.